Case 14-1988 — A 40-Year-Old Man with Rapidly Progressive Blindness and Multiple Cranial-Nerve Deficits

Presentation of CaseA 40-year-old man was admitted to the hospital because of progressive visual loss and neurologic decline.He was well until two months earlier, when there was the onset of an unremitting bilateral retro-orbital headache, which did not respond to analgesic medications. A physician found crepitus at the left temporomandibular joint, with tenderness in the external auditory canal. A computed tomographic (CT) scan of the head was reported to be normal, and imipramine was begun. During the next few weeks the patient began to notice clouding of vision in the left eye, followed by reduced vision in the . . .